From the Guidelines
Ketoconazole is not recommended for treating tinea pedis due to its poor side-effect profile and risk of hepatotoxicity. The use of oral ketoconazole was withdrawn in the U.K. and Europe in 2013 1. Although ketoconazole cream 2% may be available, its efficacy and safety for tinea pedis treatment are not well-established, and other antifungal agents are preferred.
Treatment Alternatives
- Topical antifungal agents such as terbinafine or clotrimazole are recommended for treating tinea pedis.
- Apply the cream to the affected areas and surrounding skin twice daily, in the morning and evening, for 2-4 weeks.
- Continue application for at least one week after symptoms have resolved to prevent recurrence.
Prevention
- Keep feet dry, especially between toes.
- Wear breathable footwear and change socks daily.
- Avoid walking barefoot in public areas.
- Use antifungal powder in shoes to prevent reinfection. If the infection doesn't improve after 4 weeks of treatment, or worsens at any point, consult a healthcare provider as a different treatment approach may be needed.
From the Research
Treatment Options for Tinea Pedis
- Tinea pedis, also known as athlete's foot, is a common fungal infection of the skin, with various clinical manifestations 2.
- The mainstay of treatment for superficial or localized tinea pedis is topical antifungal therapy, which can be applied once to twice daily for 1-6 weeks 2.
- Examples of topical antifungal agents include allylamines (e.g. terbinafine), azoles (e.g. ketoconazole), benzylamine, ciclopirox, tolnaftate, and amorolfine 2.
Ketoconazole for Tinea Pedis
- Ketoconazole is an azole antifungal that can be used to treat tinea pedis 2.
- However, there is limited information available on the specific use of ketoconazole for tinea pedis in the provided studies.
- Other antifungal agents, such as terbinafine, have been shown to be effective in treating tinea pedis, with shorter treatment durations and higher cure rates compared to other agents 3, 4, 5, 6.
Alternative Treatment Options
- Oral antifungal therapy, such as terbinafine, itraconazole, and fluconazole, can be used to treat severe cases of tinea pedis or in cases where topical therapy has failed 4, 2.
- Combined therapy with topical and oral antifungals may increase the cure rate 2.
- The choice of treatment should be based on the severity of the infection, the presence of other underlying conditions, and the patient's response to treatment 2.